Upgrade of ductal carcinoma in situ on core biopsies to invasive disease at final surgery: a retrospective review across the Scottish Breast Screening Programme

Sim, Yirong; Litherland, Janet; Lindsay, Eduardo A.; Hendry, Peter; Brauer, K.; Dobson, H.; Cordiner, C.; Gagliardi, Tanja; Smart, Louise

doi:10.1016/j.crad.2014.12.019

Cited by 22 publications

(14 citation statements)

References 10 publications

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“…The pathology features including nuclear grade and presence of comedo type necrosis were also not associated with upstaging, despite a prior meta-analysis by Brennan et al [5] which demonstrated an association with invasive cancer; however, this may be due in part to the smaller sample size included in our study. Previous investigators have looked at the predictive power of individual histologic or pathologic features [5, 6, 9, 25, 27–29], but only Park et al [9] constructed a nomogram to predict the occult invasiveness of DCIS patients, and obtained an AUC-ROC of 0.71 on their validation set. Although similar in performance to our current study, the previous study included DCIS patients with microinvasion, and the overall underestimation rate of DCIS patients by preoperative biopsy was 42.6% (145/340), both of which significantly decreased the difficulty of the prediction task.…”

Section: Discussionmentioning

confidence: 99%

“…Prior studies suggested relationships between outcomes of DCIS and histologic features from pathology reports [1, 5, 6, 27, 29] or BI-RADS mammographic features [5, 25–28]. Although not intended for the present task, those features nonetheless may have predictive value.…”

Section: Methodsmentioning

confidence: 98%

“…A core component of our prediction model is a computer-vision algorithm based approach to extract mammographic features (denoted as computer vision features in the remaining sections). In addition, we also extracted and evaluated some histologic features and BI-RADS (Breast Imaging Reporting and Data Systems) related mammographic features that have been used in the literature [1, 5, 6, 25–29](denoted as physician-interpreted features in the remaining sections), and compared their predictive power for occult invasive disease in DCIS with the computer vision features.…”

Section: Methodsmentioning

confidence: 99%

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Can Occult Invasive Disease in Ductal Carcinoma In Situ Be Predicted Using Computer-extracted Mammographic Features?

et al. 2017

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Rationale and Objectives This study aimed to determine whether mammographic features assessed by radiologists and using computer algorithms are prognostic of occult invasive disease for patients showing ductal carcinoma in situ (DCIS) only in core biopsy. Materials and Methods In this retrospective study, we analyzed data from 99 subjects with DCIS (74 pure DCIS; 25 DCIS with occult invasion). We developed a computer-vision algorithm capable of extracting 113 features from magnification views in mammograms and combining these features to predict whether a DCIS case will be upstaged to invasive cancer at the time of definitive surgery. In comparison, we also built predictive models based on physician-interpreted features, which included histologic features extracted from biopsy reports and Breast Imaging Reporting and Data Systems (BI-RADS) related mammographic features assessed by two radiologists. The generalization performance was assessed using leave one out cross validation with the receiver operating characteristic (ROC) curve analysis. Results Using the computer-extracted mammographic features, the multivariate classifier was able to distinguish DCIS with occult invasion from pure DCIS, with an area under the curve for ROC (AUC-ROC) equal to 0.70 (95% CI: 0.59–0.81). The physician-interpreted features including histologic features and BI-RADS related mammographic features assessed by two radiologists showed mixed results, and only one radiologist’s subjective assessment was predictive, with AUC-ROC equal to 0.68 (95% CI: 0.57–0.81). Conclusion Predicting upstaging for DCIS based upon mammograms is challenging, and there exists significant inter-observer variability among radiologists. However, the proposed computer-extracted mammographic features are promising for the prediction of occult invasion in DCIS.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 98%

Section: Methodsmentioning

confidence: 99%

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Can Occult Invasive Disease in Ductal Carcinoma In Situ Be Predicted Using Computer-extracted Mammographic Features?

et al. 2017

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“…Several published articles have shown a higher underestimation rate with the automated core-needle biopsy compared to SVAB (9-11). Sim et al (17) reported that the underestimation rate of DCIS (26%) was significantly higher when preoperative biopsies were performed using core biopsy needles, compared with the lower underestimation rate of DCIS (19.9%) in biopsies obtained using VAB devices. Although SVAB allows more accurate histopathologic results, underestimation still occurs (7,10,18).…”

Section: Discussionmentioning

confidence: 99%

Predictive factors for invasive cancer in surgical specimens following an initial diagnosis of ductal carcinoma in situ after stereotactic vacuum-assisted breast biopsy in microcalcification-only lesions

Gümüş

Mills²,

Fish³

et al. 2015

Diagn Interv Radiol

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“…Table 1 shows that the various centres use a variety of stereotactic equipment both vertical (add-on) and horizontal. Also, SCB systems in use vary, with pros and cons for each of these systems [12]. Further analysis of this aspect is, however, outside the scope of this article.…”

Section: Mammography and Radiological Classificationmentioning

confidence: 99%

Stereotactic Core Biopsy Following Screening Mammography: A Danish Retrospective National Cohort Study

Redsted¹,

Nguyen²,

Christensen³

et al. 2018

IJCM

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Background: Since introducing stereotactic core biopsy (SCB) on breast lesions in Denmark, no national follow-up of the procedure has been executed. Purpose: To evaluate performance of SCB in Danish mammography screening. 3 areas were selected for evaluation: diagnostic value of SCB, performance of the Danish 7-tier mamma-radiological classifications system, DKBI-RADS, and diagnostic delay for SCB-diagnosis. Materials & Methods: Danish retrospective national cohort study including 2195 screening patients undergoing SCB. Study period: 01.01.2010 to 30.09.2012. Patients were identified from The Danish National Patient Register. Pathology-data were obtained from the Danish Pathology Database. Radiological-data according to DKBI-RADS were recorded. Diagnostic delay from clinical mammography until diagnosis was registered. Results: 173 SCBs indicated cancer; all operated with 3 cases finalized as benign. 1296 cases were determined benign with diagnostic surgery in 81 cases of which 31 were concluded pre-malignant/malignant. Correlation between DKBI-RADS and pathology diagnosis: 329 of 485 DKBI-RADS3, 227 of 450 DKBI-RADS4 were benign. 4 of 16 DKBI-RADS5 were benign. The diagnostic value of pre-malignant/malignant SCB related to results from surgery showed 94.4% sensitivity and a positive predictive value of 93.9%. Median diagnostic-time of single-biopsy was 13 days. Conclusion: The performance of SCB in Denmark is comparable to international studies regarding the diagnostic value of malignant SCB. The study indicates that DKBI-RADS classifications are not used consistently regarding micro-calcifications selected in screen

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Upgrade of ductal carcinoma in situ on core biopsies to invasive disease at final surgery: a retrospective review across the Scottish Breast Screening Programme

Cited by 22 publications

References 10 publications

Can Occult Invasive Disease in Ductal Carcinoma In Situ Be Predicted Using Computer-extracted Mammographic Features?

Can Occult Invasive Disease in Ductal Carcinoma In Situ Be Predicted Using Computer-extracted Mammographic Features?

Predictive factors for invasive cancer in surgical specimens following an initial diagnosis of ductal carcinoma in situ after stereotactic vacuum-assisted breast biopsy in microcalcification-only lesions

Stereotactic Core Biopsy Following Screening Mammography: A Danish Retrospective National Cohort Study

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